25-8426_Form_5_Reference_Questionnaire.pdf
PDF 296 KB Posted
- Attached to
- Collection Agency Services
- Solicitation number
- 25-8426
- Issued by
- Collier County, Florida
About this file
This is a Reference Questionnaire form utilized by Collier County, Florida's Procurement Services Division for evaluating firms and key personnel bidding on the Collection Agency Services contract. The form requires proposers to provide client references who will complete a comprehensive performance evaluation. Each reference must describe a specific past project, including its description, completion date, budget, and duration. The questionnaire assesses ten performance criteria on a scale of 1 to 10, with 10 indicating the evaluator would hire the firm again and 1 indicating they would never hire the firm again. Criteria evaluated include cost management and change order minimization, schedule adherence, quality of work, consultative advice, personnel management and professionalism, project administration and documentation, communication and documentation clarity, risk management capabilities, compliance with contract documents and regulations, and overall customer satisfaction. Any criteria left blank will receive a score of zero. The form requires completion of all items and must be submitted with the bid or proposal.
The reference questionnaire is a mandatory component of Collier County's selection process for the Collection Agency Services contract, which the Emergency Medical Services Division requested through the Board of County Commissioners. The county's historical spending on these services approximates $940,000 annually, though this figure may not represent future purchasing patterns. Proposers must meet minimum specification and scope of work requirements, and results from this solicitation may be made available to other county departments following award in accordance with the Board of County Commissioners Procurement Ordinance. One completed form must be submitted for each required reference and returned with the bid or proposal submittal.
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Text version
Version 2 9.2.25
Form 5 Reference Questionnaire
(USE ONE FORM FOR EACH REQUIRED REFERENCE – FORM MUST BE FULLY COMPLETED AND RETURNED
WITH BID/PROPOSAL SUBMITTAL)
Solicitation:
Reference Questionnaire for:
(Name of Company Requesting Reference Information)
(Name of Individuals Requesting Reference Information)
Name:
(Evaluator completing reference questionnaire)
Company:
(Evaluator’s Company completing reference)
Email: FAX: Telephone:
Collier County has implemented a process that collects reference information on firms and their key personnel to be used in the selection of firms to perform this project. The Name of the Company listed in the Subject above has listed you as a client for which they have previously performed work. Please complete the survey. Please rate each criteria to the best of your knowledge on a scale of 1 to 10, with 10 representing that you were very satisifed (and would hire the firm/individual again) and 1 representing that you were very unsatisfied (and would never hire the firm/indivdiual again). If you do not have sufficient knowledge of past performance in a particular area, leave it blank and the item or form will be scored “0.”
Project Description: ___________________________ Completion Date: _____________________________
Project Budget: _______________________________ Project Number of Days: _______________________
Item Criteria Score (must be completed) 1 Ability to manage the project costs (minimize change orders to scope).
2 Ability to maintain project schedule (complete on-time or early).
3 Quality of work.
4 Quality of consultative advice provided on the project.
5 Professionalism and ability to manage personnel.
6 Project administration (completed documents, final invoice, final product turnover;
invoices; manuals or going forward documentation, etc.)
7 Ability to verbally communicate and document information clearly and succinctly.
8 Abiltity to manage risks and unexpected project circumstances.
9 Ability to follow contract documents, policies, procedures, rules, regulations, etc.
10 Overall comfort level with hiring the company in the future (customer satisfaction).
TOTAL SCORE OF ALL ITEMS
| Text25: |
| Text26: |
| Name of Company Requesting Reference Information: |
| Text27: |
| Text28: |
| Text29: |
| Text30: |
| Text31: |
| Project Description: |
| Completion Date: |
| Project Budget: |
| Project Number of Days: |
| Score must be completedAbility to manage the project costs minimize change orders to scope: |
| Score must be completedAbility to maintain project schedule complete ontime or early: |
| Score must be completedQuality of work: |
| Score must be completedQuality of consultative advice provided on the project: |
| Score must be completedProfessionalism and ability to manage personnel: |
| Score must be completedProject administration completed documents final invoice final product turnover invoices manuals or going forward documentation etc: |
| Score must be completedAbility to verbally communicate and document information clearly and succinctly: |
| Score must be completedAbiltity to manage risks and unexpected project circumstances: |
| Score must be completedAbility to follow contract documents policies procedures rules regulations etc: |
| Score must be completedOverall comfort level with hiring the company in the future customer satisfaction: |
| Score must be completedTOTAL SCORE OF ALL ITEMS: |
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